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Diagnosis of scrub typhus by immunohistochemical staining of Orientia tsutsugamushi in cutaneous lesions.
Am J Clin Pathol. 2008 Oct; 130(4):543-51.AJ

Abstract

We assessed the clinical usefulness of immunohistochemical staining on skin biopsy specimens for the diagnosis of scrub typhus compared with indirect immunofluorescent antibody assay (IFA), the definitive diagnostic method for scrub typhus, in a prospective study of 125 patients with possible scrub typhus in 2005 and 2006. Skin biopsy specimens were obtained from 63 patients. To minimize the effects caused by antibiotics on immunohistochemical results, 46 patients were assessed before antibiotic administration (4 patients received antibiotic therapy before admission; 13 underwent skin biopsy after antibiotic administration at our hospital). Compared with IFA results, immunohistochemical results on maculopapular skin lesions demonstrated a sensitivity of 0.65 and a specificity of 1. Immunohistochemical results on eschars demonstrated a sensitivity of 1 and a specificity of 1. For immunohistochemical staining performed on skin lesions within 3 or 4 days of administration of antibiotics that are effective for Rickettsia, the antibiotics did not greatly influence diagnostic sensitivity. Immunohistochemical staining of skin biopsy specimens, particularly that of eschars, is sensitive and specific, and this technique can be reliable for confirming the diagnosis of scrub typhus.

Authors+Show Affiliations

Division of Infectious Diseases, Department of Internal Medicine, Chosun University College of Medicine, Gwangju, Republic of Korea.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

18794046

Citation

Kim, Dong-Min, et al. "Diagnosis of Scrub Typhus By Immunohistochemical Staining of Orientia Tsutsugamushi in Cutaneous Lesions." American Journal of Clinical Pathology, vol. 130, no. 4, 2008, pp. 543-51.
Kim DM, Park CJ, Lim SC, et al. Diagnosis of scrub typhus by immunohistochemical staining of Orientia tsutsugamushi in cutaneous lesions. Am J Clin Pathol. 2008;130(4):543-51.
Kim, D. M., Park, C. J., Lim, S. C., Park, K. H., Jang, W. J., & Lee, S. H. (2008). Diagnosis of scrub typhus by immunohistochemical staining of Orientia tsutsugamushi in cutaneous lesions. American Journal of Clinical Pathology, 130(4), 543-51. https://doi.org/10.1309/X17HNNJKMYGHT4HP
Kim DM, et al. Diagnosis of Scrub Typhus By Immunohistochemical Staining of Orientia Tsutsugamushi in Cutaneous Lesions. Am J Clin Pathol. 2008;130(4):543-51. PubMed PMID: 18794046.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Diagnosis of scrub typhus by immunohistochemical staining of Orientia tsutsugamushi in cutaneous lesions. AU - Kim,Dong-Min, AU - Park,Chol-Jin, AU - Lim,Sung-Chul, AU - Park,Kyung-Hee, AU - Jang,Won-Jong, AU - Lee,Seung-Hyun, PY - 2008/9/17/pubmed PY - 2008/10/22/medline PY - 2008/9/17/entrez SP - 543 EP - 51 JF - American journal of clinical pathology JO - Am J Clin Pathol VL - 130 IS - 4 N2 - We assessed the clinical usefulness of immunohistochemical staining on skin biopsy specimens for the diagnosis of scrub typhus compared with indirect immunofluorescent antibody assay (IFA), the definitive diagnostic method for scrub typhus, in a prospective study of 125 patients with possible scrub typhus in 2005 and 2006. Skin biopsy specimens were obtained from 63 patients. To minimize the effects caused by antibiotics on immunohistochemical results, 46 patients were assessed before antibiotic administration (4 patients received antibiotic therapy before admission; 13 underwent skin biopsy after antibiotic administration at our hospital). Compared with IFA results, immunohistochemical results on maculopapular skin lesions demonstrated a sensitivity of 0.65 and a specificity of 1. Immunohistochemical results on eschars demonstrated a sensitivity of 1 and a specificity of 1. For immunohistochemical staining performed on skin lesions within 3 or 4 days of administration of antibiotics that are effective for Rickettsia, the antibiotics did not greatly influence diagnostic sensitivity. Immunohistochemical staining of skin biopsy specimens, particularly that of eschars, is sensitive and specific, and this technique can be reliable for confirming the diagnosis of scrub typhus. SN - 0002-9173 UR - https://www.unboundmedicine.com/medline/citation/18794046/Diagnosis_of_scrub_typhus_by_immunohistochemical_staining_of_Orientia_tsutsugamushi_in_cutaneous_lesions_ L2 - https://academic.oup.com/ajcp/article-lookup/doi/10.1309/X17HNNJKMYGHT4HP DB - PRIME DP - Unbound Medicine ER -